U.S. health officials say 93 Americans have died after cosmetic surgery in the Dominican Republic since 2009, with many of the recent deaths involving a procedure known as a Brazilian butt lift.

The operation has grown in popularity recently and has led to deaths in other countries as well, including the U.S. A report issued Thursday by the U.S. Centers for Disease Control and Prevention could not say how common these deaths are or whether they are more common in the Dominican Republic.

The report suggests steps that medical tourists should consider before traveling to get work done.